Kinsey Keller, MA, LPC
308-765-8027
10 Pinckney Colony Road,
Building 300, Suite 301,
Bluffton, SC 29909
Kinsey Keller, MA, LPC
308-765-8027
10 Pinckney Colony Road,
Building 300, Suite 301,
Bluffton, SC 29909
INITIAL FORMS
INITIAL FORMS
PLEASE READ BELOW!
Let's save time before your first session! For current safety reasons there is no option to complete in the office and must be done before your first session. If you are completing from your phone you do not need to download the app click "Sign With Mobile Browser". Know that if you are coming for marriage or couples counseling you each will need to complete your own. If you are under the age of 19 your parent will need to sign with you. Follow the tabs some are required and some are optional. At the end you will get a confirmation that your document has been sent and your welcome to download and save a copy for yourself.
If you are coming for marriage/family counseling only one person will need to complete this for the family. Even if you are paying with our cash discount the form will still need to be completed.
Click below to begin filling out the New Patient Form and Payment Information.
(REQUIRED documents below Payment and New Patient Form)
https://signnow.com/s/NqV5VpGj
https://signnow.com/s/21v9npfs
If your wanting to have anyone included in your treatment such as your primary care physician, lawyer, or family please fill out the document below.
(not required)
https://signnow.com/s/mPdCk1Rh